| Background and objectiveAlmost all types of heart and great vessels disease can cause heart failure(HF).Therefore,heart failure is the leading cause of cardiovascular death.Biomarkers play an important role in heart failure,which provide information on the pathogenesis of heart failure and identify high-risk patients for us.Brain natriuretic peptide(BNP)and N-terminal brain natriuretic peptide(NT-ProBNP)is the main marker for the diagnosis of heart failure.It has obtained full affirmation to the diagnosis of heart failure.But whether it can guide the treatment,clinical results are not consistent and expert opinion differences.In recent years,a lot of markers which diagnosis and estimate the prognosis of heart failure have emerged.Soluble ST2(sST2)and galectin-3 have become an increasingly important value to the diagnosis of heart failure as a new biomarker developed in recent years.And they have been proved that is associated with adverse events in patients with heart failure.This paper aims to study the diagnostic value of galectin-3 and sST2 by discussing the relationship between galectin-3 and sST2 with chronic heart failure’s NYHA classification,the traditional biomarker of heart failure and cardiac ultrasound indicators.And study the correlation between galectin-3,sST2 and the recent fatalities through follow-up study for a period of one month.Methods142 patients who had chronic cardiac failure treated and 85 normal people from February 2014 to October 2015 in the fourth people’s hospital of jinan were selected for the study.Patients were divided into three groups according to NYHA heart function classification criterion: NYHA Class Ⅱ,Ⅲ,Ⅳ groups.The general information was collected and the serum N-terminal brain natriuretic peptide,high-sensitivity C reactive protein,ultrasonic morphology were all examined after admission.The galectin-3 and soluble ST2 levels were determined by ELISA.For heart failure patients followed up forone month,the patient died as a follow-up endpoint.Results1.The patients of NYHA Class Ⅱ,Ⅲ,Ⅳ make a pair-wise comparison.There were significant differences in galectin-3,sST2,hs-CRP,NT-ProBNP and left ventricular enddiastolic dimension(LVEDD)(P <0.05).NYHA Class Ⅱ patients compared with the normal group,hs-CRP,NT-ProBNP and LVEDD have significant differences(P <0.05),but galectin-3 and sST2 have no significant difference between the two groups(P> 0.05).2.Galectin-3 and hs-CRP(r = 0.867,P <0.01),NT-ProBNP(r = 0.412,P <0.01)were positively correlated;sST2 with hs-CRP(r = 0.221,P < 0.01),NT-ProBNP(r = 0.582,P<0.01)were also positively correlated.sST2 and left ventricular ejection fraction(EF)was negatively correlated(r =-0.551,P <0.01).sST2 with left atrial diameter and LVEDD was positively correlated(r = 0.441,P <0.01);galectin-3 and left ventricular ejection fraction was negatively correlated(r =-0.403,P <0.01),but there was no significant correlation with the left atrial diameter and LVEDD(P> 0.01).3.ROC curve showed that,AUC of galectin-3、sST2 on diagnosing heart failure was0.738,0.771(P<0.01).4.The NT-proBNP levels in patients of heart failure before discharge was obviously decreased than that on admission(1.75 ± 1.29vs4.01 ± 3.53),and P<0.05.But Galectin-3(22.58 ± 3.28vs24.61 ± 2.93)and sST2(2.75 ± 0.93vs2.68 ± 0.59)has no significant difference(P> 0.05).5.After one month of follow-up galectin-3(21.74 ± 8.45vs30.24 ± 11.18)and sST2(2.66±0.31 vs2.92±0.74)were statistically significant differences between survival group and death group(P <0.01).Conclusion1.The concentration of galectin-3 and sST2 gradually increased with decreasing cardiac function.And galectin-3,ST2 is correlated with traditional heart failure indicator and it can be used for diagnosis of heart failure.2.The diagnostic value of galectin-3 or sST2 combined NT-proBNP is superior to NT-proBNP alone to heart failure.3.Galectin-3 and sST2 are relevant with the recent death of patients with heart failure,and they can guide the patients’ prognosis. |
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